Why Don't Employees Use EAP Services?

If your organization has an Employee Assistance Program (EAP) provider - and many do - you may already know it has great value as a coaching resource, as a career-rescue tool, and as a literal lifesaver for employees who are under severe personal and professional stress. I’ve used EAP counseling when I was in law enforcement and found it useful (for those things I saw in the field that I don’t want to see again, least of all in my dreams). I tell the participants in my training classes that I’ve used EAP and I emphasize that it’s okay to reach out for help. Yet some EAPs are under-used. Why?

There are really four reasons why employees don’t use EAP and I’ll list them in the most-frequent order: they don’t think it’s confidential; they feel there is a stigma for reaching out for help (especially for some men, who see this as a weakness); they think they have to ask permission from their boss or HR; or they don’t know it exists. Let’s tackle each one.

First, company stakeholders need to continually educate employees about how EAP works, starting with the fact that it is absolutely confidential (unless the client wants to harm himself or herself or others, then the therapist has a duty to warn or intervene). We need to remind our employees that no reports come back to the organization and that there is no external record of their use of the EAP.

Second, it makes sense to reassure employees that every one of us has similar on and off-the-job struggles. It’s no sin for people to reach out for help when the “allostatic load” (as our psychologist friends like to call it) gets piled too high and deep. Tell your employees what subjects EAP covers, including: financial problems, marital issues, raising children or step-children, blended families, sick kids, cancer, stress-related illness, parents with Alzheimer’s, grief from death or loss, at-work or line of duty deaths, gambling problems, money worries, substance abuse, eating disorders, job burnout, workplace conflicts, depression, or suicidal thoughts. Each of these concerns can be addressed urgently and competently by EAP professionals, who may have a list of resources where they can refer the employee as well.

Third, just as the use of EAP is confidential, there is no need for employees to tell anyone, ask permission, go through HR channels, or do anything other than call the EAP phone number and make an appointment. Many EAP providers are quite flexible. They will work with some employees at their therapist offices; they will work with the employee over the phone if that’s desired; or they can even meet the employee at the worksite. (Counseling an employee on the job - typically during a lunch break and in a private room - may be a necessity for the safety of all involved in a domestic violence situation where the employee cannot go to a therapy appointment.)

Lastly, the idea where the employee does not know about EAP services puzzles me the most. The program often gets a mention in new-employee orientation sessions, it’s common to see posters and brochures in the breakrooms, and forward-thinking EAP providers will come to the organization and do lunchtime presentations to introduce themselves and offer help on a variety of stressors.

My claim to fame (however modest) is that in 1994, I co-wrote one of the first business books on workplace violence. For the

book, I interviewed workplace double-murderer, Robert Mack. He was a 25-year employee of General Dynamics in San Diego, and he killed the labor relations manager handling his termination case and shot and wounded his boss, who later died. During my prison interview with him, he told me he had suffered from depression, had psychotic breaks with reality, and had a cocaine addiction. I asked him why he didn’t reach out for EAP help and he told me he hadn’t known about it. EAP services were at General Dynamics 17 of his 25 years there. Sometimes we must lead the horses to the water.

Another issue might be the way the company uses EAP. One employer I worked for made it very clear that if an employee is not conforming to their proper pigeonhole, they are BROKEN and need to go use EAP and "fix" themselves without the employer having to speak to the employee, which is too much work. The employer would then repeatedly post EAP notices, and mention in meetings that "everyone" should take advantage of EAP, but wouldn't stoop to speaking to an employee with a problem, even to let the employee know that there WAS a problem.

I sneeringly referred to it as the "psychic hotline" method of management. Call the psychic hotline, figure out that you're a problem, and use EAP to fix yourself. Don't expect management to waste time on you.

It makes little to no sense for companies to pay for an EAP and then not make sure employees know about it and that it's use is confidential. Supervisors and managers should also be trained in monitoring employee's attendance, performance and behavior to make appropriate referrals.

Referring back to the anonymous comment, of not knowing you are "broken" and no one willing to tell you, it maybe that the number one reason that people do not take the step to access EAP is one of denial that there is a problem or that other personal views of services interfere with accepting what is available to them. Was their upbringing one where the message was "we don't talk about those things outside the home"? Maybe the employer/supervisor feels very uncomfortable bringing certain things to the attention of a problematic employee, fearing a law suit. That is quite possible.

Here are some for instances: someone with an active addiction maybe in the defensive posture of denial that keeps them from acknowledging that they need assistance. Another example might be that the employee is not aware of how they are being affected by life circumstances. For example the person may not have much insight into how the death of a spouse or other family member can lead to depression. I have witnessed a Principal pass their employee off to another school rather than confront the issue of a prescription medication problem. That employee was quickly fired for failure to perform adequately at the new school. The real issue was the failure of the Principal to address the real issue, seeking to find an alternative solution that cost the employee the job.

So we can see that there are many reasons why people do not access services.

That's precisely what I was referring to: management shirking their responsibilities. If an employee is not exhibiting problematic behavior, then there is nothing for the company to act on. If the employee is exhibiting problematic behavior, it is absolutely management's responsibility to tell the employee exactly what that problem behavior is, what improvement is expected, and a time frame for doing so. That is, after all, why management is called 'management' and not 'silent observation'. If management is unwilling to do their jobs, they shouldn't whine about an employee not living up to unspoken expectations, and they shouldn't expect that employee to just somehow *know* that something is wrong. If the employee is not performing to reasonable expectation, and management is too timid or aloof to say it, then management is the problem and they need to be replaced. Or perhaps EAP can help them figure out why they are incompetent. :-)

As a publisher and distributor of free workplace posters of financial help lines, we are not an EAP but often fill in the gaps where one does not exist. Many times a caller's first question is, "Is this confidential?" And if HR explains that getting help from the EAP is never shared with co-workers or management, real doubt may remain.

The article accurately cites the male reluctance to ask for help. This extends well beyond the workplace. Men don't ask for directions while driving, and tend to choose the pioneer's act of solving their own problems. If they can't find their way, they do equate the "asking for help" with weakness. They'll even wait until help is either too little or too late. As a man, I don't blame men for this, it's just the way we've been wired since we were cave men.

Females generally reach out and call our help lines twice as often as men. Women are wired to cooperate with each other toward a solution. They don't carry the machismo or pride which prevents them from asking for help.

For information about workplace posters or other free resources, visit www.careconnectusa.org

I am starting my own consulting business, specifically, selling my live, educational, on-site, employee training to corporations in San Diego to raise awareness on mental health. I know (via years of research) that this will save companies tons of $'s due to low employee productivitu, high employee turnover, absenteeism and presenteeism resulting from untreated mental health issues employees grapple with ever day. Yet, I desperately need a partner to help me with the business, or sales, side of this, especially knowing how to get to the decision-makers. It seems like you may have a lot of knowledge in this area. Would you be willing to speak to me about this? . Sincerely, Catherine Scruggs, M.A.

First of all, thanks so much for bringing this issue to light. I have been in the EAP field since 1981 and own a company that provides EAPs. The stigma and fear of no confidentiality are big reasons people and their companies don't make full use of EAPs but there is a bigger reason. Not all EAPs are the same. What we have seen over the years is a proliferation of EAPs that are embedded in the company group health or disability insurance packages. In other words, they are low or no cost (supposedly) so employers aren't really aware of their existence and their value. This therefore leads to no promotion and low utilization. The companies we deal with are those who really "get it" and are committed to making their employees aware of the benefit just like the 401K plan or health insurance. They encourage folks to use the program and work very hard to promote its confidential nature. Using EAP as a tool for investing in employees leads to healthier workforces, greater productivity and profitability and higher retention of employees.

I have zero issues seeking any sort of assistance if I need it. However, I deserve the best help I can afford.

All too often, EAPs claim confidentiality, but offer services via internet and phone. Likely, the best EAPs are doing their utmost to follow through on this promise. But NOTHING on the internet is truly private.

Privacy laws vary by country. If an EAP company is purchased by a foreign company my information becomes subject to a different set of laws.

EAPs tend to be larger firms, or owned by large firms. That increases the probability of my information being shared. A small office with a receptionist out front suits me just fine, thanks.

Some EAPs have expanded service options to include everything but the kitchen sink. Including services that are not demonstrably effective.

If I seek any sort of professional service, I want to see a diploma or some type of proof of qualification to provide for my needs. When I go to a dentist, that proof is on the wall. If I contact an EAP, I must rely on what they choose to tell me. Worse, I've noticed that my EAP website is replete with staff claiming to have graduate degrees with no (or little) mention of majors or work experience in the field.

I'm serious about maintaining great mental health. For that reason, if required, I'll seek a qualified practitioner in my area.

Thanks for sharing your concerns. First, in terms of not having any trouble seeking assistance, that is great. I only wish others felt as comfortable as you do. Unfortunately, they don't and only part of the reason is fear of having confidentiality breached. The other part of the reason is shame and the stigma that goes along with seeking help around mental health issues. Therefore, EAPs provide an opportunity for getting assistance and hopefully before things get out of control. That is why many of the services offered by an EAP go beyond counseling. That way, people can get preventive services and trust the EAP better. In terms of confidentiality, records should not be kept with the employer (on his/her server). Secondly, any electronic communications should be encrypted. Also, you make a compelling argument for not having an EAP embedded in an insurance or disability insurer. Our role as EAP is to remain neutral, make it easy for people to access help of any kind (as a resource) and help people navigate the many avenues of help so that they can live and work more productively.

My personal problem with the EAP our company uses isn't that it's there but rather that we're required to use it in order to receive psychological services. If I have a broken arm, I'm not required to call a hotline and then be referred to an emergency room. If I have the flu, I'm not required to call a hotline and then be referred to a physician. And yet if I have an eating disorder or need to speak to someone about depression, I'm first required to speak to the EAP hotline. How does that make sense? It's another hoop to jump through for people who are far less likely to want to jump through hoops. And quite frankly it's just another way that "mental illness" is segregated into a separate category from all other illness. I firmly believe that far more employees would seek out psychological treatment were they not forced to jump through that extra hoop. A patient should be able to log in to their insurance, choose the appropriate provider and then make the appointment.

Add to that, the dwindling number of qualified therapists who are accepting EAP. Last time I used the service, I was given a choice of 5 therapists, the closest being 30 miles away! But I had to see an EAP approved therapist before the additional psychiatric benefits kicked in so travel I did. Ridiculous!!

Robyn, I totally understand your concern about feeling "forced" to go through the EAP to address your issues. However, in my experience working for an EAP, they are generally *voluntary* programs that you may choose to use or not use. Typically, if you have personal issues that you'd like to see someone about, you can choose to use the EAP provider, or choose to use any other provider via your private insurance or self-pay. The EAP is nice because you get some free sessions, but I've never heard of it being required in order to obtain additional services. I would recommend that you discuss your concerns with your HR or benefits representative - maybe your employer just needs a better EAP.

Just to clarify. The ONLY option my company gives for psychological care is through EAP. Otherwise you pay out of pocket. If you call the EAP, you do get 4 free sessions and only then do the mental health benefits kick in. And the company uses a separate company for mental health than they do for regular insurance. So the ONLY way you get mental health assistance is through calling the EAP number. We aren't even provided a separate number that leads directly to our mental health insurance. We have to go through EAP.

I have sought EAP psychological help at two major companies I've worked for. In the first experience, the counselor's office was one of a long row of tiny little offices. The counselor seemed disinterested, just going through the motions. The whole place seemed like a "counseling factory." I did not go back.

In the second experience, the counselor was solo, but his office looked like it hadn't been cleaned in years. The furniture was falling apart. He was also a very poor counselor.

I have had multiple counselors I have sought out on my own, using health insurance. I did not click with all of them, but most I did. They were all of a noticeably higher caliber than the EAP folks. EAP is a joke.

I utilized my organization's EAP shortly before I quit. When I had my exit interview with an HR representative, she said "and you can finish out any sessions with EAP that you already received an authorization for.......I mean, I don't know if you used EAP because that's confidential".......and she was stuttering and back pedaling the entire time she discussed EAP. I spoke to two others who left, and asked them about their exit interviews, and both said the EAP was never discussed with them. So.....EAP proponents can laud the EAP and say it's confidential, but I do not believe it's confidential, and I will never utilize an EAP again.

What I'm reading are very individualized frustrations with specific scenarios related to using EAP. Most of these issues are ones I've heard before-- confidentiality concerns, poor caliber of counseling, companies using EAP as a disciplinary measure, or as a gate-keeper for mental health coverage.... All of these are legitimate problems, and I'm sorry to hear that anyone has had to deal with them.

HOWEVER-- these issues would not occur if an EAP and the company that is purchasing it follow industry guidelines. There are very specific "best-practices" that prevent these very serious concerns.
The problem? EAP is not a regulated industry. That means a company can call itself an EAP and sell/deliver services in whatever manner they choose-- even poorly-- and it's legal.
Just like you would carefully inspect a car or home before you buy it, a company MUST examine what their EAP is truly providing. There are some big-box EAPs out there that are spectacular marketers-- they offer a shiny product and come in at ridiculously cheap rates. But at the end of the day, no one uses it and if they do, they get poor quality services. It's really a shame, because so many people hear the term "EAP" and think, "poor quality" or "scam," when in actuality, a well-run EAP is the BEST early intervention for all types of day to day problems, and a solid prevention intervention for all forms of workplace violence.
Of course, a well run EAP is almost always a more expensive EAP...... you really do get what you pay for, but one of the most beautiful things about EAP is that when it works well, the company should actually SAVE money by having one.

The take-away? Do your research. If you find that your EAP is not very good, anonymously notify your employer and ask them to explore other vendors. Some EAPs truly do offer excellent support.

I appreciate this article and am citing it on a website that I'm creating content for. That said, another site is using your writing word for word and claiming that it was written by one of their own authors. Take a look -- http://www.feinet.com/news/why-employees-don%E2%80%99t-use-eap-services